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High blood pressure and obesity: disparities among four French Overseas Territories

Inamo, Jocelyna; Daigre, Jean-Loupb; Boissin, Jean-Louisc; Kangambega, Paulined; Larifla, Laurente; Chevallier, Helenef; Balkau, Beverleyg,h; Smadja, Didieri; Atallah, Andrej

doi: 10.1097/HJH.0b013e328348fd95
Original papers: Epidemiology
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Background and purpose The epidemiological characteristics of hypertension and obesity in French Overseas Territories (FOTs) have never been compared.

Methods This cross-sectional survey included representative population-based samples of 602, 601, 620 and 605 men and women aged more than 15 years, respectively, from four FOTs of Guadeloupe, Martinique, French Guiana, and French Polynesia. Hypertension was defined as blood pressure (BP) at least 140/90 mmHg or the current use of antihypertensive treatment.

Results The prevalence of hypertension was 29.2% in Guadeloupe, 17.9% in French Guiana, 27.6% in Martinique and 24.5% in French Polynesia. Considering the Guadeloupe population as the reference group, prevalence of hypertension was significantly lower in French Guiana (P < 0.001), even after controlling for age and sex (P = 0.006). Awareness and treatment of hypertension were similar in French Guiana, Martinique and Guadeloupe (68.8–75.1% and 69.0–73.4%, respectively). Awareness was lower in French Polynesia (50.0%, adjusted P value = 0.04), as was treatment of hypertension (32.4%, adjusted P value = 0.001). Control of hypertension was also lower in French Polynesia (8.8%, adjusted P value = 0.001) compared with the other territories (29.7–31.8%). French Polynesia had the highest prevalence of obesity (33.1%, adjusted P value < 0.001) as compared with the other territories (17.9–22.8%). It had also the largest population attributable fraction of hypertension due to obesity (35.5%) compared with Guadeloupe (13.3%), Martinique (12.3%) and French Guiana (23.6%).

Conclusion Wide variations were observed in the prevalence and the management of hypertension between these FOTs, and an especially challenging low control of hypertension was found in French Polynesia. Obesity appears a key target to prevent hypertension, particularly in French Polynesia.

aDépartement de Cardiologie, Hopital de Fort de France, Inserm U558, IFERISS,Toulouse, Universite Antilles et de la Guyane, Pointe à Pitre, Guadeloupe

bDépartement de Diabetologie, CH de l’Ouest Guyanais, Saint Laurent du Maroni, French Guiana

cDépartement de Diabetologie, Papeete, French Polynesia

dDépartement de Diabetologie, CHU Pointe à Pitre

eDépartement de Cardiologie, Hopital de Pointe à Pitre, Pointe à Pitre, Guadeloupe

fInstitut CSA, Paris

gINSERM CESP, Centre for Research in Epidemiology and Population Health U1018

hUniversity Paris Sud 11, UMRS 1018, Villejuif, France

iDépartement de Neurologie, Hopital de Fort de France, Fort de France, Martinique

jDépartement de Cardiologie, Hopital de Basse-Terre, Guadeloupe

Correspondence to Dr Inamo Jocelyn, Département de Cardiologie, Centre Hospitalier Universitaire de Fort de France BP 632, 97200 Fort de France, Martinique Tel: +596 596 55 2171; fax: +596 596 75 8439; e-mail: Jocelyn.inamo@chu-fortdefrance.fr

Abbreviations: FOTs, French Overseas Territories; IDF, International Diabetes Federation; NCEP, National Cholesterol Education Program Adult Treatment Panel III; PAF, population attributable fraction

Received 22 October, 2010

Revised 21 April, 2011

Accepted 19 May, 2011

© 2011 Lippincott Williams & Wilkins, Inc.